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Health outcomes, as exemplified by higher rates of death, tend to be poorer outside major cities. The main contributors to higher death rates in regional and remote areas are coronary heart disease, other circulatory diseases, motor vehicle accidents and chronic obstructive pulmonary disease (e.g. emphysema). These higher death rates may relate to differences in access to services, risk factors and the regional/remote environment.

Clear differences exist in health service usage between areas. There are, for example, lower rates of some hospital surgical procedures, lower rates of GP consultation and generally higher rates of hospital admission in regional and remote areas than in major cities. There are also inter-regional differences in risk factors; for example, people from regional and remote areas tend to be more likely than their major cities counterparts to smoke and drink alcohol in harmful or hazardous quantities. It is also likely that environmental issues such as more physically dangerous occupations and factors associated with driving (for example. long distances, greater speed, isolation, animals on roads and so on) play a part in elevating accident rates and related injury death in country areas.

However, it is not currently possible to apportion the generally poorer health outcomes outside major cities to access, environment or risk factor issues. It is likely that each of these three play a part.

Higher death rates and poorer health outcomes outside major cities, especially in remote areas, also reflects the higher proportions of the populations in those areas who are Aboriginal or Torres Strait Islander. Overall, death rates for Indigenous people tend to be much higher than for non-Indigenous people for a number of reasons (see The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples 2008).

Data quality issues, the limited nature of available data-sets, poor identification of Indigenous people in data collections and differences between the operation of health systems in major cities and regional and remote areas, can often make comparison difficult.

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